Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 6842 | CO |
NPI | 1003151077 |
---|---|
Provider Name | Rodrigo D. Rodriguez |
First Address | Aurora, CO 80018-6012 |
Second Address | Aurora, CO 80018-6012 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/12/2012 |
Last Update Date | 28/03/2015 |